Insomnia is one of the most common presenting symptoms in the primary care setting as well as in psychiatric offices. Whereas the incidence of persistent insomnia can be as high as 10% in the general population, rates can be as high as 20% in primary care settings and 50% in psychiatric settings.
Treatment options for insomnia include pharmacotherapy, behavior therapy, and psychological interventions. Although medication is used most frequently in both primary care and psychiatric settings, behavioral and psychological interventions, along with alternative therapies, can be beneficial.
One alternative is sleep hygiene education, which is intended to provide information about lifestyle and environmental factors that may interfere with or promote sleep. Sleep hygiene guidelines include avoiding all stimulants, including caffeine and nicotine, several hours before bedtime; not drinking alcohol around bedtime, because it fragments sleep; exercising regularly, especially in the late afternoon or early evening; finishing eating at least 2 to 3 hours before regular bedtime; keeping the bedroom environment quiet, dark, and comfortable; and sleeping on a comfortable mattress and pillow.
One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
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